A broad range of surgical techniques directed to the abdominal cavity are carried out using laparoscopic procedures. For example, in abdominal microsurgery or video laparoscopic surgery, a patient is placed under general anesthesia, and the abdomen is then inflated with a nonflammable inert gas such as CO.sub.2 in order to transform the abdominal cavity from a virtual to an actual cavity. The provision of the cavity affords the laparoscopic surgeon the space within which laparoscopic tools and implements can be manipulated in order to carry out the laparoscopic procedure.
In order to accomplish the surgery or similar procedure, "trocars" are inserted that traverse the abdominal wall. A trocar is a rigid tube with gas-tight membranes that prevent the inflating gas from escaping from the abdomen during the procedure. Thereupon, a series of microimplements are inserted into the abdominal cavity through the trocars. These include, for example, a light source and video camera for visualizing the procedure, and other instruments for actually carrying out the surgical operation or similar procedure.
For a surgical operation of this kind, several trocars, frequently four or more, are normally used. Two of the trocars permit access to the abdomen by the video camera in order to monitor the movements of the implements introduced, and permit devices or apparatuses required in the procedure to be introduced into the cavity; these include, for example, implants or catheters intended for embedding within an abdominal tissue or organ to be implanted in the patient. The remaining trocars are used to introduce laparoscopic forceps, other implements, and laparoscopic surgical instruments required for the surgeon to perform the maneuvers undertaken during the operation.
Laparoscopic forceps are among the implements that are of fundamental importance to the successful outcome of a laparoscopic procedure. However, the intra-abdominal manipulation of forceps that are currently available is not always easy. This results in lengthening the duration of the operation, with all the disadvantages and inconveniences such a situation may cause. Extending the time under anesthesia is, of course, detrimental to the patient. Awkwardness in handling surgical instruments within the abdomen may lead to inadvertent injury of adjacent tissues or organs. Additional maneuvers required through a trocar provide additional opportunity for consequential infection from the procedure. In addition, forceps such as those currently available, tend to lose functional effectiveness fairly quickly due to the significant stresses and resulting deformation to which they are subject during the operation. For example, if the implement is a suture needle, the stress, especially stress due to torque, may lead to deformation of the forceps. Furthermore, the forceps do not always have strong grasping power. The grasping power additionally tends to diminish with use due to wear. This may result in potentially harmful changes in position of the implement being grasped, such as a suture needle, particularly when it must be supported and held at a certain angle in relation to the forceps to facilitate suture by the surgeon. When laparoscopic forceps lose their grasping capability, or become deformed, they must be discarded in order to avoid adverse effects on the patient and the procedure. This leads to increased hospital costs.
Forceps that grasp instruments or implements introduced through a trocar during laparoscopic procedures also are frequently called upon to grasp a piece of tissue or a portion of an organ in order to juxtapose the tissue or organ with a laparoscopic implement such as a suture needle. A forceps used to grasp an implement may not always be suitable to grasp a tissue or organ, and vice versa. Such failings lead to a requirement for a multiplicity of laparoscopic forceps to be introduced into the abdominal cavity.
Furthermore, implements currently used in laparoscopic procedures commonly do not have surfaces that are easily grasped without longitudinal or angular slippage. Frequently they may have smooth surfaces and contours that are symmetrical or uniform. Such surfaces are not easily or controllably grasped by a forceps. Implements in question that may fail to be easily grasped or controlled include, for example, laparoscopic suture needles, stylets, devices or implants intended for installation in an abdominal tissue or organ, and the like.
Thus, there remains a need for laparoscopic forceps that have good grasping power and convenient endoscopic maneuverability, thus producing a reduction in the time required to carry out an endoscopic procedure. There furthermore is a need for laparoscopic forceps whose usefulness lasts for an extended amount of time without undergoing deformation under stress. There additionally is a need for a laparoscopic forceps that avoid slippage and twisting of the implement being held. In particular, there remains a need for a forceps that can hold and support a laparoscopic implement such as a suture needle at a particular angle in relation to the shaft of the forceps so as to facilitate its maneuverability by the surgeon. There further remains a need for laparoscopic forceps that are not subject to significant stress during the operation caused, for example, by the torsion of the needle while making the suture stitches.
There further is a need for laparoscopic forceps that permit a laparoscopic implement, such as a needle, when it is grasped, to be automatically oriented in an optimal position for the surgeon to carry out a surgical objective, such as to implant a surgical suture under the guidance of the laparoscopic camera with optimal effectiveness. There is still further a need for laparoscopic forceps that not only grasp and hold an implement, such as a suture needle, in an intended orientation, but that also grasps tissue and organs or can be employed in other maneuvers required during the laparoscopic operation being performed.
The forceps and methods of this invention address and meet such needs. Moreover, the forceps and methods of the present invention eliminate and/or solve the above-mentioned disadvantages of currently existing forceps, particularly as regards known types of laparoendoscopic suture forceps.